| NPI | 1518400530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: CA 127759) | |
| 106H00000X Marriage & Family Therapist | |
| 172V00000X Community Health Worker | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2021-10-07 |